Sunday, June 26, 2011

Thalassemia patient



I received a mail from a reader regarding Thalassemia patient dietary guide, I have deal with this kind of cases before and I don't mind to share it to all littlediet fans. 
Thalassemia is an inherited autosomal recessive blood disease, to make it simple, there are 2 types of case. The first one is thalassemia major (2 defective genes which need undergo therapy) and the second one is minor (carriers, no symptoms). If the patient is received blood transfusion, then they may need to control the intake of high iron foods. This is related with iron overload problem if blood transfusion but at the same time consumption of high iron foods. Thalassemia is a type of anemia disease. The early destruction of red blood cells cause the oxygen unable be sent to tissues and cells. That's why they need on blood transfusion. The example of high iron foods: seafoods (squid, clams, oysters), internal organs (liver, small intestine, brain), fish roe, raisin, beans, spinach, appropriate amount of chicken, beef and pork. Some of them may also take zinc supplement to chelate (compete) binding with iron to remove excess iron. Besides, patients are encouraged to take tea, coffee, milk, carbonated drink together with meal time to avoid iron absorption. However, they need to avoid taking rich vitamin c  (fruit juice, orange yellow fruits) together with meal as it encourages iron absorption.


地中海贫血可以是一种隐性遗传血液病简单的说,它可分为两种第一个是较严重地中海贫血需要接受治疗,第二种是轻微带菌者,无自觉症状)。如果病人接受输血那么他们可能需要控制高铁质的食物摄入量。地中海贫血是一种贫血的类型,红血细胞的早期破坏导致氧气无法被发送到组织和细胞,这就是为什么他们需要输血海产品鱿鱼,牡蛎(肝,小肠,脑内脏鱼子葡萄干,豆类,菠菜鸡肉,牛肉和猪肉适量都是高铁的食物例子。其中可能需要补充螯合物,以除去多余的铁结合此外,患者用餐时应尝试咖啡,牛奶等饮料,避免铁的吸收。他们也必须避免吸丰富的维生素C(果汁黄色的水果),因为它鼓励铁的吸收。

Thursday, June 23, 2011

Career development as a Dietitian

Since May, I have been receiving several emails from young reader (this 2 months are the "season" for high school leavers to choose courses for their university) who wish to know more about the career path as a dietitian. They mostly need information about job scope, opportunities and market demand as a dietitian. Honestly speaking, the resources that explain the career of dietitian are limited especially when it comes to real work life sharing from a dietitian. Well, I wish to take this opportunity to explain it, but take note that my thought and information mostly regarding to the career development of a dietitian in my country Malaysia. I compile all question into few Q&A for readers to understand:

a) What is the scope of job for dietitian in Malaysia?
They are few kind of dietitians - Clinical dietitian (that's me, normally work in hospital), community dietitian, food service dietitian, research dietitian (R&D on the hidden usefulness of food) and business dietitian (Marketing but requires dietitian knowledge). 


b) Any advice how to become a good dietitian?
 It is really a need of interest, good communication skill and be patient in doing your job (You are not doctors or pharmacist, so sometimes not every patient or medical specialist will follow your order) . Besides providing dietary consultation, you may deal with some critical illness patient for feeding regime. It is actually quite challenging, critical thinking is a need and good conversation skill with patient (especially speak in different language with people from all sort of race). 


c) Is dietitian a lower class of medical professional?
There is no such thing as who is more important or non-important for medical professional from my opinion, a medical center needs various expertise of people to manage all patients and increase the level of healthcare industry.


d) I heard not every people aware of seeking consultation from a dietitian, so could it be a boring job?
This is very subjective, it depends on area and which type of hospitalization. Normally, government hospital has lots of patient and therefore the case refer from doctors to dietitian increase as well (you can get around 8 patients daily), private hospital is different, not every patient will be refer to dietitian and one main point is patients are not paying to see dietitian, some charges include in the hospitalization package. Once again, it depends on the size of your hospital and area too. If you are working in non-city and non-central hospital, yes, sometimes dietitian is quite free in office. Clinical dietitian needs to give talks to community or any special events once a while (probably once in a month), so it is not easy to become a clinical dietitian. 


e) How to become a successful dietitian?
I can only give opinion from a scope of a clinical dietitian, you can continue pursue study to obtain a phd degree and  get a title of Dr, based on your research knowledge and specific domain, you can get a very well recognizable profile in industry for certain knowledge. Business dietitian earns the most from my opinion (not to compare with a dietitian with phd degree), they sell products and get commission as well, but you need to have marketing skills too.


f) Is clinical dietitian job achieves lowest vacancy compare to other types? 
As mention, each hospital needs few dietitian only and that also applies to larger organization. You must know what kind of dietitian you want to be, work in a hospital/medical center or you have a better social skill which I suggest you to work as nutritionist or consultant. Working in a hospital requires great responsibility.


g) Is it frustrating when people do not listen to your medical advice?
This is a very common question I received. My answer would be no. You have try your best, leave the rest for the will of the patient whether they choose to follow or not. You must always be prepare and well study to provide good explanations in supporting your advice. That's the responsibility.

h) Is it dietitian getting a low paid and appreciation in Malaysia?
This is a tricky question. It depends on whether you value your job most or your paid first. Business dietitian (for example, consultant that sells healthcare package) receives low basic paid too when entering the field, but with hard work and experience, they are gaining the most plus the experience working with hospital party and community side. The entry paid for dietitian in different countries are almost similar except you might take into account of currency.


i) In short, what is the advice for fresh nutrition/dietitian student?
Your path may varies on the road of your studying in degree and you may not know what will you end up after graduate, so my advice is plan well on your study, read more on medical professionals research work, and you will get a clearer picture of what you want to end up in. For me, I didn't really look on salary and burden of work when I join as clinical dietitian. I took a helpful and caring heart to dive into this area than anything.

I am welcome for any dietitian to share with me their career path and their thought of a job as a dietitian/nutritionist. Cheers.

Thursday, June 16, 2011

E.coli - What's it?



I hope all reader are aware of lately one of the hottest topic of food is E.coli. A large exposure in Germany on  E.coli bacteria infection through raw vegetables (the first trace of the root of infection is cucumber and now is confirmed from bean sprouts sources grown on a farm in northern Germany). It is being suspected the reason behind is due to contaminated water that use for bean sprouts as water supply. Germany Robert Koch Institute (RKI) has announced that contaminated bean sprouts were the source of the outbreak. Travelers should aware that the recommendation not to eat cucumbers, tomatoes and leafy salads.
I took some time to study these kind of case before sharing on my blog. The specific E.coli strains that cause outbreaks of disease in this incident are named as E.coli 0104:H4. Patients may experienced hemorrhagic colitis (inflammation and bleeding of the colon). Let's know what can E.coli cause, EHEC and HUS. EHEC 
is refer as Hemorrhagic (bloody) diarrhea: an increased amount of blood in the diarrheal stool that doesn't
resolve and is usually accompanied by severe abdominal pain. Although this may resolve within a week, some individuals can develop anemia and dehydration that can cause death. Hemolytic-uremic syndrome (HUS) : symptoms of pallor (due to anemia), fever, bruising or nose bleeding, fatigue, shortness of breath, swelling of the body, especially hands and feet, jaundice, and reduced flow of urine may be seen. HUS symptoms usually develop about 7 to 10 days after the initial diarrhea begins. HUS is the most common cause of kidney failure in children that damage the kidneys and destroys platelets which can lead to kidney failure, excessive bleeding, seizures or death.
Prevention includes eating well cooked foods, and drinking treated or pasteurized fluids. Avoiding touching or eating any food that may be contaminated with any animal or human waste will help to prevent the infection too. When you are preparing any fresh produce, begin with clean hands. Wash the produce under running water just before preparing or eating. This includes produce that grown conventionally or organically at home, or produce that is purchased from a grocery store or farmer's market.
Furthermore, proper storage of fresh produce can affect both quality and safety. Certain perishable fresh fruits and vegetables (like strawberries, lettuce, herbs, and mushrooms) can be best maintained by storing in a clean refrigerator at a temperature of 40° F or below. All produce that is purchased pre-cut or peeled should be refrigerated to maintain both quality and safety.

Folks, prevention is better than cure. Do practice a good hygiene as a first step to good health. Cheers.

最近在德国有一个关于蔬菜类被大肠杆菌种类的细菌感染(一开始被怀疑的是黄瓜,现在证实了豆芽)。这是因为怀疑受污染的水被作为豆芽的水源。德国罗伯特科赫研究所(RKI)日前宣布,受污染的豆芽是此次感染爆发的根源。德国公众卫生当局目前建议,劝人们不要吃生豆芽。建议不吃黄瓜,西红柿和绿叶沙拉在德国北部已在610日解除
诊断是通过发现大肠杆菌病在粪便里。大多数大肠杆菌感染的解决是自发的,不需要治疗。但是,如果病人变得脱水,贫血(血损失过多,由于出血性腹泻),密切的治疗是需要
我翻查了一些资料。使疾病暴发的大肠杆菌在这一事件被称为的大肠杆菌0104H4。有些患者经历(炎症和结肠出血)​​出血性结肠炎。此类大肠杆菌会出现在受污染的水,食物和未经高温消毒或不正确消毒(热处理)乳制品等。一个人可能会被污染一旦接触到的带菌者,受污染的食物或液体

预防此类细菌包括吃煮熟的食物,饮用处理或消毒了的干净水。避免接触或食用任何可能与受感染的动物或人类粪便接触
正确的新鲜农产品储存,可影响质量和安全。某些易腐新鲜水果和蔬菜(如草莓,生菜,草药和蘑菇)最能维持在一个干净的冰箱储存在一个40 ° F或以下的温度。如果你不能确定是否应冷藏为维护品质,在还未买时请您询问详情。所有购买预先切开或去皮的食物应该冷藏以维持质量和安全


Monday, June 13, 2011

Protein via vegetarian diet

If you followed my previous post, I mentioned it is true vegetarian diet plan may suffer from deficient in nutrients especially in proteinGrain foods, such as bread, cereal, pasta, rice, nuts, beans and tofu are just few vegetable-based foods that contain protein. We can get complete protein by eating a varieties of plant foods. For example, grains are low lysine and moderate methionine while legumes are low methionine, moderate lysine. Thus, if we take this 2 types of foods, can enable our body to have a complete protein that we need. 
I include a table to explain my planning on vegetarian diet for adequate protein supply. 

Grains
Legumes
Nuts/Seeds
 Barley
Beans
Sesame seeds
Wheat
Lentils
Sunflower seeds
Cornmeal
Dried peas
Walnuts
Oats
Peanuts
Cashews
Rye
Chickpeas
Pumpkin seeds
Rice
Soy products
Other nuts
Pasta




Example menu to learn how to combine different source of plant to provide a complete protein for our body.

Foods
Limiting Amino acids
Completementary foods
Example menu
Legumes: lentils, peas, beans
Trytophan, methionine
Grains, nuts and seeds
Legumes+ grains
Grains: wheat, corn, rice, oats, barley, rye
Lysine, isoleucine, Threonine
Legumes
Grains + legumes
Nuts & seeds: Almonds, peanuts, sunflower, cashews
Lysine, isoleucine
Legumes
Nuts / seeds + legumes


许多植物类食物含有蛋白质。这包括谷物,面包,面食,大米,果仁,豆类,豆腐。事实上,如果我们能够得到全部的氨基酸,我们就可以得到完整的蛋白质。例如,谷物低赖氨酸和适中的蛋氨酸,而豆类含低蛋氨酸和适中的赖氨酸,我们同时食用这种食物,将确保获得完整的蛋白质。以下图表显示的各种植物来源和基础的素食蛋白质组合,创造互补性蛋白质。


坚果/
芝麻
葵花
米,米
干豌
核桃
燕麦
花生
腰豆
黑麦
南瓜
荞麦种
面食
大豆制成品
坚果



食物
氨基酸
互补食物
建议组合
豆类:扁豆,豌
色氨,蛋氨
谷物,坚果和种
豆类+坚果和种子/谷物
谷物类:小麦,玉米,水稻,燕麦,大麦,黑
赖氨酸,异亮氨酸,苏氨
豆类
+豆类
坚果和种子:杏仁,花生,葵花籽,腰
赖氨酸,异亮氨
豆类
坚果/种子+

Thursday, June 9, 2011

Vegetarian diet - Protein?


Littlediet continues with the topic of vegetarian diet. When we develop vegetarian diet in our daily life, we directly practice a healthier eating habit. As known, vegetarian diet can increase vegetables, legumes, nuts and fruits consumption and reduce meats intake. Meats especially red meats (beef, lamb, pork) contain high saturated fat and cholesterol (for skin part, fatty part, internal organs (liver, heart)). Meats will make our blood more acidity while plant sources of foods make our blood alkaline. Our body needs a neutral condition for optimal organ function. When we reduce those harmful substance intake and replace with healthier green foods, those healthy foods will acts as a cleaner to help us detoxify those harmful substances and alkaline blood stream in our body. Thus, well balanced vegetarian diet is appropriate for all stages of life.
Vegetarian diets have been described as being deficient in several nutrients including protein, iron and others nutrient. Therefore we should include as complete as possible for type Amino acids (protein) in our daily meal. Unless we plan carefully, else vegetarian diet may be nutritional inadequate. Plant sources of protein include legumes (soybeans; peanut; beans (pinto, navy, baked beans, red beans, mung beans, kidney bean), and peas (blackeye, chickpea), grains, nuts and seeds. Plant sources of protein differ from animal sources such as meat, milk, and eggs in that most plant sources are not complete proteins. A complete protein is one that contains all the essential Amino acids (EAA) in sufficient amount for growth and maintenance tissue support. Those EAA is unable to be produced by our body but is needed in our body. Therefore, a vegetarian who doesn't plan his/her meal right may end up suffering from low level of one or more essential amino acids. Well, you don't really need complete proteins all in the same meal, simply make sure you eat a variety of protein sources throughout the day, from nuts to seeds, to rice and grains. Another option is to get some soy into vegetarian diet because it offers a complete protein. To vegetarian, take note of diet planning!

素食可以增加摄取蔬菜,豆类,坚果和水果;同时减少肉类摄取。红肉(牛肉,羊肉,猪肉)含有饱和脂肪和胆固醇(尤其皮,脂肪部分和内脏。过多的肉类摄取会使我们的血液酸度过高,反而植物性食含碱性能使身体得以维持中性。我们的身体需要较为中性的情况以达到最佳的器官功能。当我们减少这些有害物质的摄入和增加健康食物,这些含碱性的食物可帮助我们的身体排出有害物质和保持血液的中性性质。当我们食用素食,我们应该尽可能地摄取所有类型(蛋白质)的氨基酸在我们的日常膳食中。植物蛋白质来源包括黄豆,花生,豆类(扁豆,红豆,绿豆),豌豆,谷类,坚果和种子。植物来源的蛋白质不同于动物来源,如肉类,牛奶,鸡蛋。大多数植物源是不完整的蛋白质。一个完整的蛋白质是可增长和维护组织含有所需的氨基酸。食用足够的氨基酸才可完全可以得到充足的营养。所以,请确保你在一天的蛋白质来源,坚果种子至大米和谷物。另一种选择是黄,因为它提供了一个完整的蛋白质。
因此,别犹豫了,好好地培养食用蔬果类的习惯,你将能够得到一个健康的身体和支持爱护环境吧!

Saturday, June 4, 2011

A BMI widget

Few days ago when I was trying on blogspot widget to find if any BMI calculator to be added into my page, it turns out to be widget with ads or Europe standard of measurement parameters. So I decided to write one, this is my first time writing HTML code and I hope is good enough to produce a simple and nice widget. Anyway, HTML5 tutorials lessen my job a lot. From here as a starting point, I will roll out more calculator for dietary related in future. Based on the BMI calculator I designed, it is in kilogram for weight and centimeter for height. If you wonder how to convert from a standard to another, below provide a little tips for you all.

You are 1.61 m, 50 kg
weight:

1kg=2.2 pounds
50kg=50x 2.2=110 pounds

height:
1 feet= 12 inches
1 inches= 2.54 cm
1.61m= 161 cm
161 divide by 2.54 =63.4 inches
63.4 divide by 12= 5 feet 3 inches

Thursday, June 2, 2011

Vegetarian diet



Hi, littlediet is back. The new topic will be covering all about vegetarian, just because I found that there are lesser related information we can grab online. Choosing between a vegetarian diet and a meat-eating diet is a very personal and individual decision that should be made with as much information and education as possible. 
If you plan to include 1 to 2 times of vegetarian diet in your weekly meal, you are giving yourself a chance to enjoy more variety of vegetables at the same time support for earth to reduce dependency on animals and animal’s products. Besides, you might be able to avoid some negative consequences of animals and animals products on our bodies. This is relating with some issues that animals are raised with the use of antibiotics and growth hormones, especially commercial meats (sausage, nugget, ham and others processed foods). Farmers use antibiotics on their livestock to prevent them from the diseases of animals while growth hormones are being used for animals to grow larger in a short period. This can let them earn more in a short season. Recently, there are news reports about fake meats being sold around the market (Although I haven't encounter similar case in hospital, these kind of case is popular among society). Thus, we should choose products from reliable supplier or try to reduce frequency of consuming meats and say 'hi' to vegetarian diet. But, is vegetarian diet provide us the adequate nutrient we need daily? Is vegetarian diet suitable for children who are having growing period? The answer to this question will be reveal slowly in next few post. Cheers.


如果你能够在每星期养成食用12次的素食饮食,你其实能够摄取到更多的蔬果和豆类营养,同时能够支持地球,减少对动物或动物肉类制成品的依赖。在同一时间,您可避免动物和动物肉类制成品对我们的身体造成的不良成分。这是因为有关动物的抗生素和生长激素,特别是动物肉类制成品(香肠,火腿等加工食品)。农民使用抗生素,以防止他们的牲畜患上疾病,而生长激素用于使动物在短期内快速成长,以便可以在短期类赚取盈利。最近,一些新闻报道有关于各种假肉类销售在各地市场里。因此,我们应选择可靠的供应商的产品或尽量减少食用肉类的频率,开始养成食用素食。接下来,我会和大家解释素食的种种好处和习惯。